Method for inserting an intraocular lens

ABSTRACT

An injector for inserting an intraocular lens into an eye includes a lumen. The lumen can include a terminal portion at a distal end and a proximal portion juxtaposed with the terminal portion. An injector plunger can be disposed within the lumen for generating a driving force on the intraocular lens. The injector can include a lens frictional force that has a first value when the lens is at a first location within the proximal portion and a second value when the lens is at a second location within the terminal portion. The first value can be smaller than the second value. In some embodiments, the lens frictional force increases abruptly from the first value to the second value as the lens approaches the distal end of the lumen.

BACKGROUND OF THE INVENTIONS

1. Field of the Inventions

Various embodiments disclosed herein pertain to insertion of intraocularlenses into the eye of a patient, as well as methods and devices forpreparing an intraocular lens for insertion, and for achieving theinsertion itself.

2. Description of the Related Art

Artificial intraocular lenses are often implanted to replace orsupplement the natural crystalline lens. Such a lens may be implantedwhere the natural lens has developed cataracts or has lost elasticity tocreate a condition of presbyopia. Implantation devices have beendeveloped to roll or fold an intraocular lens, and/or assist inimplanting a rolled or folded lens through a small incision in thepatient's eye. However, these known implantation devices suffer fromvarious drawbacks, many of which are addressed by certain embodimentsdisclosed herein.

SUMMARY OF THE INVENTIONS

In certain embodiments, an injector for inserting an intraocular lensinto an eye comprises a lumen. The lumen can comprise a terminal portionat a distal end and a proximal portion juxtaposed with the terminalportion. The lumen can further comprise an inner surface. In someembodiments, the injector further comprises an injector plunger at leastpartially disposed within the lumen for generating a driving force onthe intraocular lens. The driving force can cause the intraocular lensto move within the lumen. The lens can move through the proximal portionbefore the terminal portion. In some embodiments, the injector comprisesa lens coefficient of friction between the inner surface and theintraocular lens when the lens is moving through the lumen. The lenscoefficient of friction can be associated with a lens frictional forcethat resists the driving force. The lens coefficient of friction canhave a first value when the lens is at a first location within theproximal portion and a second value when the lens is at a secondlocation within the terminal portion. The first value can be smallerthan the second value.

In some embodiments, as discussed further below, an increase from thefirst lens coefficient of friction to the second lens coefficient offriction can advantageously provide a tactile feedback to a userindicating that the lens is at or near the distal end of the lumen.

In some embodiments, an injector for inserting an intraocular lens intoan eye comprises a lumen. The lumen can comprise a terminal portion at adistal end and a proximal portion juxtaposed with the terminal portion.The lumen can further comprise an inner surface. The injector cancomprise an injector plunger at least partially disposed within thelumen for generating a driving force on the intraocular lens. Thedriving force can cause the intraocular lens to move within the lumen.The lens can move through the proximal portion before the terminalportion. In some embodiments, the injector comprises a lens coefficientof friction between the inner surface and the intraocular lens when thelens is moving through the lumen. The lens coefficient of friction canbe associated with a lens frictional force that resists the drivingforce. The lens frictional force can have a first value when the lens isat a first location within the proximal portion and a second value whenthe lens is at a second location within the terminal portion. The firstvalue can be smaller than the second value. In some embodiments, thelens frictional force increases abruptly from the first value to thesecond value as the lens approaches the distal end of the lumen. Anincrease in the lens frictional force from the first value to the secondvalue can provide a tactile feedback to a user indicating that the lensis near the distal end of the lumen.

In some embodiments, an injector for inserting an intraocular lens intoan eye comprises a lumen. The lumen can comprise a terminal portion at adistal end and a proximal portion juxtaposed with the terminal portion.The lumen can further comprise an inner surface. The injector cancomprise an injector plunger at least partially disposed within thelumen. The plunger can be configured to generate a driving force on theintraocular lens that causes the intraocular lens to move within thelumen. The lumen can be configured such that the lens can move throughthe proximal portion before the terminal portion. In some embodiments,the inner surface is configured to cooperate with the intraocular lensto give rise to a lens coefficient of friction when the lens is movingthrough the lumen. The lens coefficient of friction can be associatedwith a lens frictional force that resists the driving force. The lensfrictional force can have a first value when the lens is at a firstlocation within the proximal portion and a second value when the lens isat a second location within the terminal portion. The first value can besmaller than the second value. In some embodiments, the lens frictionalforce increases abruptly from the first value to the second value as thelens approaches the distal end of the lumen. In some embodiments, anincrease in the lens frictional force from the first value to the secondvalue can provide a tactile feedback to a user indicating that the lensis near the distal end of the lumen.

In certain embodiments, an injector for inserting an intraocular lensinto an eye comprises a lumen. The lumen can comprise a terminal portionat a distal end and a proximal portion juxtaposed with the terminalportion. The lumen can further comprise an inner surface. The injectorcan comprise an injector plunger at least partially disposed within thelumen for generating a driving force on the intraocular lens. Thedriving force can cause the intraocular lens to move within the lumen.The lens can move through the proximal portion before the terminalportion. The plunger can comprise an abutting surface in facingrelationship to the inner surface. In some embodiments, the injectorcomprises a plunger coefficient of friction between the inner surfaceand the abutting surface when the plunger is moving through the lumen.The plunger coefficient of friction can be associated with a plungerfrictional force that resists the driving force. The plunger frictionalforce can have a first value when the lens is at a first location withinthe proximal portion and a second value when the lens is at a secondlocation within the terminal portion. The first value can be smallerthan the second value. In some embodiments, an increase in the plungerfrictional force from the first value to the second value can provide atactile feedback to a user indicating that the lens is near the distalend of the lumen.

In certain embodiments, a method is provided for operating an injectorhaving an intraocular lens disposed therein. The injector comprises alumen having a terminal portion at a distal end thereof and a proximalportion juxtaposed with the terminal portion. The lumen comprises aninner surface. In some embodiments, the method comprises exerting afirst lens frictional force on the intraocular lens when the lens is ata first location within the proximal portion. The first lens frictionalforce can be associated with a first lens coefficient of frictionbetween the lens and the inner surface. The method can further compriseexerting a second lens frictional force on the intraocular lens when thelens is at a second location within the terminal portion. The secondlens frictional force can be associated with a second lens coefficientof friction between the lens and the inner surface. The second lenscoefficient of friction can be larger than the first lens coefficient offriction.

In certain embodiments, a method is provided for operating an injectorhaving an intraocular lens disposed therein. The injector can comprise alumen having a terminal portion at a distal end thereof and a proximalportion juxtaposed with the terminal portion. The lumen can comprise aninner surface. In certain embodiments, the method comprises advancingthe intraocular lens toward the distal end of the lumen. The method cancomprise exerting a first lens frictional force on the intraocular lenswhen the lens is at a first location within the proximal portion. Thefirst lens frictional force can be associated with a first lenscoefficient of friction between the lens and the inner surface. Themethod can comprise exerting a second lens frictional force on theintraocular lens when the lens is at a second location within theterminal portion. The second lens frictional force can be associatedwith a second lens coefficient of friction between the lens and theinner surface. The second lens frictional force can be larger than thefirst lens coefficient of friction. The method can comprise abruptlytransitioning from the first lens frictional force to the second lensfrictional force.

In some embodiments, a method is provided for operating an injectorcomprising a lumen and a plunger at least partially disposed within thelumen. The lumen can comprise a terminal portion at a distal end and aproximal portion juxtaposed with the terminal portion. The lumen canfurther comprise an inner surface. An intraocular lens can be disposedin the injector. In some embodiments, the method comprises exerting afirst plunger frictional force on the plunger when the lens is at afirst location within the proximal portion. The first plunger frictionalforce can be associated with a first plunger coefficient of frictionbetween the abutting surface and the inner surface. The method cancomprise exerting a second plunger frictional force on the plunger whenthe lens is at a second location within the terminal portion. The secondplunger frictional force can be associated with a second plungercoefficient of friction between the abutting surface and the innersurface. The second plunger frictional force can be larger than thefirst plunger frictional force. An increase from the first plungerfrictional force to the second plunger frictional force canadvantageously provide a tactile feedback to a user indicating that thelens is near the distal end of the lumen.

In certain embodiments, an injector for inserting a dual-opticintraocular lens into the anterior chamber an eye comprises a tubularsection having a lumen for conveying the dual-optic intraocular lens ina compacted condition along the tubular section with one optic in frontof another optic. The injector can further comprise a release controlsection at a distal end portion of the tubular section. The releasecontrol section can be sized to fit within the anterior chamber when theinjector is positioned in the eye for injection of the dual-opticintraocular lens into the anterior chamber. The release control sectioncan resist passage of the intraocular lens through the portion of theinjector within the anterior chamber such that release of mechanicalenergy stored in the compacted dual-optic intraocular lens is slowed.

In some embodiments, a method for injecting an intraocular lenscomprising multiple optics into an eye comprises providing an injectorhaving the intraocular lens positioned in an injection lumen with atleast one optic in front of another optic. The method can furtherinclude inserting a release control section of the injector into the eyesuch that substantially the entire release control section is in theanterior chamber of the eye. The method can also include advancing theintraocular lens to the release control section. In some embodiments,the method includes using the release control section to significantlyretard further advancement of the intraocular lens into the eye. Therelease control section can inhibit sudden release of mechanical energystored in the compacted intraocular lens and slow entry of theintraocular lens from the injector into the anterior chamber. Otherembodiments are also disclosed.

BRIEF DESCRIPTION OF THE DRAWINGS

Having thus summarized the general nature of the inventions, certainpreferred embodiments and modifications thereof will become apparent tothose skilled in the art from the detailed description herein havingreference to the figures that follow, of which:

FIG. 1 is a front view of one type of single-lens IOL.

FIG. 2 is a side view of one type of multiple-lens IOL.

FIG. 3 is a perspective view of one embodiment of an apparatus forcompacting and/or inserting an intraocular lens.

FIG. 4 is a perspective view of the apparatus of FIG. 3, with the upperhousing portion removed for clarity.

FIG. 5 is an exploded view of the apparatus of FIG. 3.

FIG. 6 is a perspective view of the lower housing of the apparatus ofFIG. 3.

FIG. 7 is a second perspective view of the lower housing of theapparatus of FIG. 3.

FIG. 8 is a third perspective view of the lower housing of the apparatusof FIG. 3.

FIG. 9 is a perspective view of the upper lens compactor of theapparatus of FIG. 3.

FIG. 10 is a second perspective view of the upper lens compactor of theapparatus of FIG. 3.

FIG. 11 is a perspective view of the upper housing of the apparatus ofFIG. 3.

FIG. 12 is a second perspective view of the upper housing of theapparatus of FIG. 3.

FIG. 13 is a perspective view of the apparatus of FIG. 3, with the upperhousing portion removed for clarity, and the upper lens compactor movedto the first compacted position.

FIG. 14 is a perspective view of the apparatus of FIG. 3, with the upperhousing portion removed for clarity, and the upper lens compactor movedto the second compacted position.

FIG. 15 is a schematic, side cross-sectional view of the apparatus ofFIG. 3, with the upper lens compactor in the home position.

FIG. 16 is a schematic, side cross-sectional view of the apparatus ofFIG. 3, with the upper lens compactor in the first compacted position.

FIG. 17 is a schematic, front cross-sectional view of the apparatus ofFIG. 3, with the upper lens compactor in the first compacted position.

FIG. 18 a schematic, front cross-sectional view of the apparatus of FIG.3, with the upper lens compactor in the second compacted position.

FIG. 19 is an upper perspective view of the pinion wheel of theapparatus of FIG. 3.

FIG. 20 is a lower perspective view of the pinion wheel of the apparatusof FIG. 3.

FIG. 21 is an exploded view of a second embodiment of an apparatus forcompacting and/or inserting an intraocular lens.

FIG. 22 is a second, partial exploded view of the apparatus of FIG. 21.

FIG. 23 is a perspective view of the apparatus of FIG. 21, with theupper housing removed for clarity.

FIG. 24 is a perspective view of the injector plate of the apparatus ofFIG. 21.

FIG. 25 is a perspective view of the upper lens compactor of theapparatus of FIG. 21.

FIG. 26 is a second perspective view of the upper lens compactor of theapparatus of FIG. 21.

FIG. 27 is a perspective view of the compactor actuator of the apparatusof FIG. 21.

FIG. 28 is a second perspective view of the compactor actuator of theapparatus of FIG. 21.

FIG. 29 is a perspective view of the lower housing of the apparatus ofFIG. 21.

FIG. 30 is a schematic, cross-sectional view of alternative engagementfaces for use with the disclosed apparatus.

FIG. 31 is a schematic, cross-sectional view of vacuum-type engagementfaces for use with the disclosed apparatus.

FIG. 32 is a schematic, cross-sectional view of vacuum-type engagementfaces for use with the disclosed apparatus, with the upper lenscompactor in the first compacted position.

FIG. 33 is a perspective view of another embodiment of an injector foran intraocular lens system.

FIG. 34 is a perspective view of the injector of FIG. 33, with the lenssystem in a displaced condition.

FIG. 35 is a perspective view of the injector of FIG. 33, with the lenssystem in a displaced and folded/crushed/compacted condition.

FIG. 36 is a perspective view of the injector of FIG. 33, with the lenssystem in the displaced and folded/crushed/compacted condition and anactuator thereof removed.

FIG. 37 is a perspective view of the injector of FIG. 33, with the lenssystem in the displaced and folded/crushed/compacted condition and aplunger thereof advanced forward.

FIG. 38 is a partial side cross-sectional view of a housing of theinjector of FIG. 33.

FIG. 39 is a detail perspective view of the actuator and lens system.

FIG. 40 is a detail perspective view of compacting members of theinjector of FIG. 33.

FIG. 41 is a perspective view of the housing.

FIG. 42 is a side cross-sectional view of the operation of the actuator.

FIG. 43 is a perspective view of the injector.

FIG. 44 is a rear detail view of one of the compacting members.

FIG. 45 is a perspective view of another embodiment of the injector.

FIG. 46 is a side cross-sectional view of the injector of FIG. 45.

FIG. 47 is another side cross-sectional view of the injector of FIG. 45.

FIG. 48 is a partial side cross-sectional view of another embodiment ofthe injector.

FIG. 49 is a schematic partial top cross-sectional view of an embodimentof an injector.

FIG. 50 is a schematic partial top cross-sectional view of the injectorof FIG. 49 showing the presence of a driving force and a frictionalforce.

FIGS. 51A, 51B, and 51C display three profiles representing separatemanners in which a coefficient of friction can vary with distancebetween a first location and a second location within an injector.

FIG. 52 is a schematic partial top cross-sectional view of an embodimentof an injector having a partially coated inner surface.

FIG. 53 is a schematic partial top cross-sectional view of an embodimentof an injector having grooves at a terminal portion thereof.

FIG. 54A is a partial perspective view of an embodiment of an injectorhaving an angled tip that includes a plurality of grooves arranged in apattern.

FIG. 54B is an enlarged view of the angled tip shown in FIG. 54A showingthe grooves in more detail.

FIG. 54C is a view similar to that shown in FIG. 54B illustratinggrooves arranged in another pattern.

FIG. 54D is a view similar to that shown in FIG. 54B illustratinggrooves arranged in another pattern.

FIG. 55 is a schematic partial top cross-sectional view of anotherembodiment of an injector.

FIG. 56 is a schematic partial top cross-sectional view of the injectorof FIG. 55 showing the presence of a driving force and a frictionalforce.

FIG. 57 is a schematic partial top cross-sectional view of anotherembodiment of an injector.

FIG. 58 is a schematic partial top cross-sectional view of the injectorof FIG. 57 showing an expansion member in an expanded state andretaining a first optic of an embodiment of an intraocular lens.

FIG. 59 is a schematic partial top cross-sectional view of the injectorof FIG. 57 showing the expansion member retaining a portion of a secondoptic of the intraocular lens.

FIG. 60 is a schematic partial perspective view of an embodiment of aninjector having a flattened end.

FIG. 61 is a schematic partial side cross-sectional view of the injectorof FIG. 60.

FIG. 62 is a schematic partial side cross-sectional view of anotherembodiment of an injector having a flattened end.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

FIGS. 1 and 2 depict two known types of intraocular lenses (“IOLs”)which are suitable for implantation in a human or animal eye to replaceor supplement the natural crystalline lens. An IOL may be implanted, forexample, when the natural lens has developed cataracts or has lostelasticity to create a condition of presbyopia.

FIG. 1 is front view of a conventional single-lens IOL 100 comprising anoptic 102 to which are connected two or more haptics 104, 106. The optic102 typically has a refractive power which is selected to replace oradjust the optical performance of the natural lens. The haptics 104, 106comprise spring-like members which fix the optic in an appropriatelocation (e.g., inside the ciliary capsule or between the cornea andiris). The IOL 100 has an optical axis generally orthogonal to andcentered on the optic; accordingly, in FIG. 1 the optical axis isdepicted as a point. In addition, the IOL 100 has a transverse axisorthogonal to the optical axis and passing through arbitrarily chosentop and bottom points of the IOL 100, and a lateral axis orthogonal tothe optical and transverse axes, and passing through arbitrarily chosenleft and right points of the IOL 100. (The top, bottom, left and rightpositions are said to be “arbitrarily chosen” because the IOL 100 can beemployed in a variety of orientations within the eye, so long as theoptical axis is substantially coincident with the optical axis of theeye itself.)

FIG. 2 is a side view of a dual- or multiple-lens IOL 120 comprisingfirst and second viewing elements 122, 124 which are interconnected bytwo or more biasing members 126, 128. One or both of the viewingelements 122, 124 may comprise an optic having refractive power. An IOLof this type is typically implanted in the ciliary capsule such that thebiasing members maintain one of the viewing elements 122, 124 againstthe anterior region of the ciliary capsule, and the other of the viewingelements 122, 124 against the posterior region of the ciliary capsule.The biasing members 126, 128 may be constructed to have spring-likeproperties to permit the separation between the viewing elements 122,124 to change in response to changes in the shape of the ciliary capsulethat occur during accommodation.

Like the single-lens IOL 100, the multiple-lens IOL 120 has an opticalaxis, transverse axis and lateral axis, arranged depicted in FIG. 2. Inthe unstressed configuration shown in FIG. 2, the optical axes of theindividual viewing elements 122, 124 are substantially coincident withthe optical axis of the IOL 120 itself. However, as discussed below theoptical axes of the individual viewing elements 122, 124 may be madenon-coincident or non-coaxial during compaction of the IOL 120.

Various types of multiple-lens IOLs are disclosed in U.S. Pat. No.7,118,596, issued on Oct. 10, 2006, titled ACCOMMODATING INTRAOCULARLENS SYSTEM, and U.S. Pat. No. 6,884,261, issued on Apr. 26, 2005,titled METHOD OF PREPARING AN INTRAOCULAR LENS FOR IMPLANTATION. Theentire contents of the above-mentioned publication and the entirecontents of the above-mentioned patent are hereby incorporated byreference herein and made a part of this specification.

Intraocular lenses are typically implanted (after any removal of thenatural lens) by first folding or rolling the IOL. The folded/rolled IOLis then inserted into the desired location in the eye by passing the IOLthrough one or more incisions made in the cornea, sclera and/or ciliarycapsule. Once in place, the natural resilience of the IOL causes it toreturn, either partially or completely, to its originalunrolled/unfolded state, whereupon the IOL can function as desired toimprove the patient's vision.

FIGS. 3-20 depict one embodiment of an apparatus 200 for compactingand/or inserting an intraocular lens. The depicted apparatus 200 (aswell as the other embodiments depicted and/or described herein) may, butneed not, be employed to compact and/or insert an intraocular lens,including without limitation IOLs of the types depicted in FIG. 1 orFIG. 2, those described in the publication and patent mentioned above,or any suitable single- or multiple-lens IOL.

With reference now to FIGS. 3-5, the apparatus 200 preferably comprisesan upper housing 202 and a lower housing 204 which cooperate to encloseand support the components of the apparatus 200. The lower housing 204preferably forms a delivery probe 206 which in turn defines a deliverylumen 208; both the delivery probe 206 and lumen 208 extend along alongitudinally-oriented delivery or injection axis A-A of the apparatus200. The lower housing 204 also preferably forms a lower lens compactoror lower compacting element 210 comprising a lower engagement face orwall 212 and a lower insertion channel 214 which extends along thedelivery axis A-A.

As best seen in FIG. 8, the lower engagement face 212 preferablycomprises a generally flat surface which defines a plane extendinggenerally parallel to (or intercepting) the delivery axis A-A. The lowerinsertion channel 214 is preferably a partial cylinder in shape, with aninner surface 216 which extends from the lower engagement face 212 to alower channel edge 218 which preferably extends generally parallel tothe delivery axis A-A. The lower insertion channel 214 preferablycomprises a partial rearward extension, along the delivery axis A-A, ofthe inner surface of the delivery lumen 208. From the lower channel edge218 a lower support surface 220 extends in a direction opposite thelower engagement face 212, while forming a generally flat surface whichdefines a plane extending preferably generally parallel to the face 212.

Referring again to FIGS. 3-5, and also to FIGS. 9-10, an upper lenscompactor 240 is slidably disposed generally above the lower lenscompactor 210. The lower and upper lens compactors 210, 240 togetherform a lens compactor of the apparatus 200. The depicted embodiment ofthe upper lens compactor 240 forms an upper engagement face 242 whichpreferably comprises a generally flat surface which, when the upper lenscompactor is in position on the lower housing 204, defines a planeextending generally parallel to the delivery axis A-A. The upper lenscompactor 240 preferably further comprises an upper insertion channel244, which is preferably a partial cylinder in shape, with an innersurface 246 which extends from the upper engagement face 242 to an upperchannel edge 248 which preferably extends generally parallel to thedelivery axis A-A. (Alternatively, the insertion channels 214, 244 maytaper inward as they extend forward, thereby forming a truncated cone oranother inward-tapering surface upon their convergence when the upperlens compactor 240 is in the second compacted position (see below).Instead of or in addition to such a configuration of the insertionchannels 214, 244, the inner surface of the delivery lumen 208 may alsotaper inward as it extends forward.)

In yet another embodiment, the delivery lumen 208 can have a generallyoval cross-section (taken orthogonal to the delivery axis), with thechannels 214, 244 shaped to have a similarly oval cross-section upontheir convergence when the upper lens compactor 240 is in the secondcompacted position (see below).

The upper lens compactor 240 preferably further comprises first andsecond upper bearing surfaces 260, 262 disposed on respective oppositesides of the upper engagement face 242 and upper insertion channel 244,as well as a third upper bearing surface 264, which extends forward fromthe second upper bearing surface 262. The first, second and third upperbearing surfaces 260, 262, 264 preferably comprise generally flatsurfaces which extend longitudinally, the first and second upper bearingsurfaces 260, 262 being sloped with respect to the upper engagement face242 and/or delivery axis A-A. The first and second upper bearingsurfaces 260, 262 are (at least initially) slidably disposed againstsimilarly-sloped first and second lower bearing surfaces 266, 268 formedon support ribs 270, 272 of the lower housing 204.

With reference now to FIGS. 3-5 and 9-12, the upper lens compactor 240preferably also forms a compactor actuator 280 which, in the depictedembodiment, comprises a generally vertically-extending member suitablefor manipulation by the thumb of a user. The compactor actuator 280 isreceived in a compactor guide 282 formed in the upper housing 202. Inthe depicted embodiment, the compactor guide 282 comprises alongitudinal slot 284 and a lateral slot 286 which are joined in an “L”configuration.

The upper and lower bearing surfaces 262, 264, 266, 268, and thecompactor actuator 280 and compactor guide 282, coact to permit theupper lens compactor 240 to advance forward and downward from a homeposition (see FIGS. 3, 4, 15) in which the compactor actuator 280 isrearwardly disposed in the longitudinal slot 284, to a first compactedposition (see FIGS. 13, 16) in which the compactor actuator 280 isforwardly disposed in the longitudinal slot 284, but has not yet beenadvanced laterally. This advancement of the upper lens compactor 240moves the upper engagement face 242 forward and downward with respect tothe lower engagement face 212, thereby reducing the vertical separationbetween the engagement faces 212, 242. The compactor actuator 280 andcompactor guide 282 likewise coact to permit the upper lens compactor240 to advance laterally from the first compacted position to a secondcompacted position (see FIGS. 14, 18) in which the compactor actuator280 is laterally disposed in the lateral slot 286, remote from thelongitudinal slot 284.

FIGS. 15-18 illustrate schematically the operation of the compactors210, 240 in a circumstance in which a multiple-lens IOL, such as the IOL120 described above, is stored or placed in the apparatus 200 forsubsequent compaction and/or insertion. In FIG. 15, the upper lenscompactor 240 is in the home position wherein the upper engagement face242 is preferably generally parallel to the lower engagement face 212,and the multiple-lens IOL 120 is disposed between the faces 212, 242,preferably in a substantially unstressed condition in which the opticalaxes of the viewing elements are substantially coincident with eachother, and/or with the optical axis of the IOL 120 itself.

Note that the IOL 120 is considered to be substantially unstressed evenwhen the faces 212, 242 compress the viewing elements 122, 124 togethersomewhat, thereby slightly stressing the biasing members 126, 128.Accordingly, the separation between the faces 212, 242 may be chosen toslightly compress the viewing elements 122, 124 together when the upperlens compactor 240 is in the home position. The IOL 120 is alsoconsidered to be substantially unstressed when the faces 212, 242 drawthe viewing elements 122, 124 apart somewhat, thereby slightly stressingthe biasing members 126, 128. The separation between the faces 212, 242may therefore be chosen to draw the viewing elements 122, 124 slightlyapart when the upper lens compactor 240 is in the home position. The IOL120 is also considered to be substantially unstressed when the outerfaces or other portions of one or both of the viewing elements 122, 124are deformed or stressed due to adhesion stresses between the faces 212,242 and the viewing elements (which stresses can arise where the viewingelements 122, 124 comprise optics), as such stresses are relativelyminor when viewed in the context of the entire IOL 120.

In the depicted embodiment, the engagement faces 212, 242 can comprisegenerally flat surfaces constructed from a material to which the outerfaces of the viewing elements 122, 124 will tend to self-adhere. Forexample, acetal (sold as DELRIN™) may be employed to construct one orboth of the faces 212, 242; this material displays good adhesionproperties with many of the materials (e.g., silicone, polyurethanes,hydrogels, acrylics, PVA, styrene-based copolymers) typically employedto construct IOLs. Of course, any other material having good adhesionproperties with the contacted portions of the IOL may be employed toform the engagement faces 212, 242. Materials having a lower coefficientof friction than that of acetal can also be used to construct theengagement faces 212, 242. For example, one or both of the engagementfaces 212, 242 can be constructed from polycarbonate.

From the home position depicted in FIG. 15, the upper engagement face242 advances forward and downward, as indicated by the arrow B, to thefirst compacted position shown in FIGS. 16-17. With the upper engagementface in the first compacted position, the IOL 120 assumes a firstcompacted condition (also shown in FIGS. 16-17) in which the viewingelements 122, 124 are relatively displaced so that they are non-coaxial.(In other words, the optical axes OA1, OA2 of the individual viewingelements are non-coincident with each other, and/or with the opticalaxis of the IOL 120 itself.) In the depicted embodiment, the viewingelements 122, 124 are sufficiently relatively displaced when in thefirst compacted condition that no portion of the first viewing element122 overlaps any portion of the second viewing element 124. However, inother embodiments the viewing elements 122, 124 may overlap somewhat(while being nonetheless non-coaxial), as the IOL 120 is viewed alongthe optical axis, while the IOL 120 is in the first compacted condition.Likewise, in the depicted embodiment no portion of the first viewingelement 122 overlaps any portion of the second viewing element 124, asthe IOL 120 is viewed along the transverse axis, when the IOL 120 is inthe first compacted condition. However, in other embodiments the viewingelements 122, 124 may be sufficiently relatively displaced that theyoverlap somewhat, as the IOL 120 is viewed along the transverse axis,while the IOL 120 is in the first compacted condition. In still anotherembodiment, the IOL 120 may have an overall height, as measured alongthe optical axis, no greater than that of the higher of the first andsecond viewing elements 122, 124, when the IOL is in the first compactedcondition. In the embodiment depicted in FIGS. 16-17, the height of theIOL 120, as measured along the optical axis, is substantially equal tothe sum of the heights of the first and second viewing elements 122,124.

As best seen in FIG. 17, when the upper lens compactor 240 is in thefirst compacted position, the upper channel edge 248 preferably contactsthe lower engagement face 212 and the lower channel edge 218 preferablycontacts the upper engagement face 242. In certain embodiments, thelower support surface 220 may also contact the upper engagement face242. If desired, the IOL 120 may be lubricated when in the firstcompacted condition, using any suitable lubricant. The lubricant mayassist in further compaction of the IOL 120.

From the first compacted position, the upper lens compactor 240 may beadvanced laterally to the second compacted position (see FIGS. 14, 18).As the upper lens compactor 240 is so advanced, the upper engagementface 242, inner surface 246 and/or upper insertion channel 244 urge theIOL 120 generally laterally toward the inner surface 216 and lowerinsertion channel 214. As best seen in FIG. 18, when the upper lenscompactor 240 is in the second compacted position the upper insertionchannel 244 is preferably disposed adjacent the lower insertion channel214 such that they form a substantially complete cylinder which issubstantially centered on the delivery axis A-A and forms a rearwardextension of the delivery lumen 208. Accordingly, the inner surfaces216, 246 and insertion channels 214, 244 “crush” the IOL 120 into asecond compacted condition shown in FIG. 18.

With further reference to FIGS. 3-5 and 9-10, the apparatus 200preferably further comprises a generally cylindrical driving member 290which is disposed along the delivery axis A-A. (Where the delivery lumen208 has an oval cross-section, the driving member 290 may have asimilarly oval cross-section.) The rearward end of the driving member290 is connected to a rack 292 which forms rack teeth 294 on one sidethereof. A pinion wheel 296 is rotatably mounted on a pinion wheelbearing 298 which projects upward from the lower housing 204. The pinionwheel 296, shown in further detail in FIGS. 19-20, forms on itsunderside a pinion gear 300 comprising pinion teeth 302 which areconfigured to mesh with the rack teeth 294, upon manual advancement ofthe rack 292 and driving member 290 forward from a storage position(shown in FIGS. 4, 13-14) to a ready position (not shown) in which theforwardmost rack teeth 294 engage the pinion teeth 302. Once the rack294 and driving member 290 reach the ready position, the user maymanipulate the pinion wheel 296 via knurling 304 formed on the outersurface thereof, to advance the rack 294 and driving memberlongitudinally forward in the apparatus 200. As this is done, ratchetcogs 306 formed on an inner surface of the pinion wheel 296 cooperatewith a ratchet pawl 308 formed on the upper housing 202 to preventcounter-rotation of the pinion wheel 296 or rearward motion of the rack294 and driving member 290.

Where the IOL 120 has been compacted into the second compactedconfiguration (or is otherwise disposed in the lower insertion channel214 or between the insertion channels 214, 244 when the upper lenscompactor 240 is in the second compacted position), this forwardmovement of the driving member 290 causes the forward end of the drivingmember to advance through the lower insertion channel (or between theinsertion channels 214, 244 when the upper lens compactor 240 is in thesecond compacted position), thereby urging the IOL 120 forward and intothe delivery lumen 208 of the delivery probe 206. Further advancement ofthe driving member will then extrude the IOL from the forward end of thedelivery probe 206.

Except where otherwise noted, the components of the apparatus 200 may beformed from any suitably rigid material, including plastics such as ABSor polycarbonate. The lower housing 204 (or, alternatively, at least thelower lens compactor 210 and/or delivery probe 206) may be formed from atransparent plastic such as clear polycarbonate, to promote visibilityof the IOL during compaction/delivery.

Accordingly, the apparatus 200 may be employed to deliver or insert anIOL, such as the IOL 120, into an eye, such as a human eye. In doing so,the user/physician first accesses an insertion location (e.g., thecapsular bag, anterior chamber, etc) within the eye via any suitabletechnique, for example, by making a small incision or series of smallincisions in the anterior structures of the eye. If necessary, thenatural crystalline lens is removed via a suitable technique such asphacoemulsification. Through the incision(s) the physician inserts theforward end of the delivery probe 206, preferably after compacting theIOL as detailed above and, if desired, after advancing the IOL partwaythrough the lumen 208 of the delivery probe 206. With the end of thedelivery probe in place, the physician extrudes the IOL from the probe206, thereby inserting the IOL in the eye. (By employing the apparatus200, the compacting and delivery may be done without opening the housing202/204 or otherwise manually accessing the IOL.) Upon departure fromthe probe 206, the IOL “un-compacts” by virtue of its elasticity,returning substantially to its unstressed condition. The physician thenwithdraws the probe 206 and, if necessary, adjusts the positioning ofthe IOL within the eye. Upon satisfactory positioning of the IOL, thephysician closes the incision(s) to complete the operation.

FIGS. 21-29 depict another embodiment of an apparatus 400 for compactingand/or inserting an intraocular lens. In one embodiment, the apparatus400 is generally similar to the apparatus 200 described above anddepicted in FIGS. 3-20, except as further detailed below. Except whereotherwise noted, the components of the apparatus 400 may be formed fromany suitably rigid material, including plastics such as ABS orpolycarbonate.

The apparatus 400 preferably comprises an upper housing 402 and a lowerhousing 404 which cooperate to enclose and support the components of theapparatus 400. Disposed within the lower housing 404 is an injectorplate 405 which forms a delivery probe 406 which in turn defines adelivery lumen 408; both the delivery probe 406 and lumen 408 extendalong a longitudinally-oriented delivery or injection axis A-A of theapparatus 400. The injector plate 405 also forms a lower lens compactoror lower compacting element 410 comprising a lower engagement face orwall 412 and a lower insertion channel 414 which extends along thedelivery axis A-A.

Best seen in FIG. 24, the lower engagement face 412 preferably comprisesa generally flat surface which defines a plane extending generallyparallel to (or intercepting) the delivery axis A-A. The lower insertionchannel 414 is preferably a partial cylinder in shape, with an innersurface 416 which extends from the lower engagement face 412 to a lowerchannel edge 418 which preferably extends generally parallel to thedelivery axis A-A. The lower insertion channel 414 preferably comprisesa partial rearward extension, along the delivery axis A-A, of the innersurface of the delivery lumen 408. From the lower channel edge 418 alower support surface 420 extends in a direction opposite the lowerengagement face 412, while forming a generally flat surface whichdefines a plane extending generally parallel to the face 412. In thedepicted embodiment, the lower support surface is slightly elevated withrespect to a lower lateral surface 422 extending from the lower supportsurface 420 opposite the lower insertion channel 414. If desired, alubricant opening 424 and lubricant fitting 426 may be provided in fluidcommunication with the lower lens compactor 410 to facilitatelubrication of the IOL during compaction.

The opening 424 also facilitates visibility of the IOL within theapparatus 400 at various stages of the compaction/delivery process. Tofurther promote visibility of the IOL during compaction/delivery, awindow or opening 407 may be formed in the lower housing 404 (see FIGS.21-22, 28), and the lower engagement face 412 (or the entire injectorplate 405) may be formed from a transparent material. Where the entireinjector plate 405 is constructed from a transparent material, thepost-compaction condition of the IOL will be visible in the deliveryprobe 406.

Referring again to FIGS. 21-22 and also to FIGS. 25-26, an upper lenscompactor 440 is slidably disposed generally above the lower lenscompactor 410. The lower and upper lens compactors 410, 440 togetherform a lens compactor of the apparatus 400. The upper lens compactor 440forms an upper engagement face 442 which preferably comprises agenerally flat surface which, when the upper lens compactor is inposition on the lower housing 404, defines a plane extending generallyparallel to the delivery axis A-A. The upper lens compactor 440preferably further comprises an upper insertion channel 444, which ispreferably a partial cylinder in shape, with an inner surface 446 whichextends from the upper engagement face 442 to an upper channel edge 448which preferably extends generally parallel to the delivery axis A-A.(Alternatively, the insertion channels 414, 444 may taper inward as theyextend forward, thereby forming a truncated cone or anotherinward-tapering surface upon their convergence when the upper lenscompactor 440 is in the second compacted position (see below). Insteadof or in addition to such a configuration of the insertion channels 414,444, the inner surface of the delivery lumen 408 may also taper inwardas it extends forward.)

In yet another embodiment, the delivery lumen 408 can have a generallyoval cross-section (taken orthogonal to the delivery axis), with thechannels 414, 444 shaped to have a similarly oval cross-section upontheir convergence when the upper lens compactor 440 is in the secondcompacted position (see below).

The upper lens compactor 440 preferably further comprises first andsecond upper bearing surfaces 460, 462 disposed on respective oppositesides of the upper engagement face 442 and upper insertion channel 444.The first and second upper bearing surfaces 460, 462 preferably comprisegenerally flat surfaces which extend longitudinally and are sloped withrespect to the upper engagement face 442 and/or delivery axis A-A. Thefirst and second upper bearing surfaces 460, 462 are (at leastinitially) slidably disposed against similarly-sloped first and secondlower bearing surfaces 466, 468 formed on support ribs 470, 472 of thelower housing 404 (see FIG. 29). The upper lens compactor 440 furthercomprises an interface slot 450 which mates with an interface tab 452formed on a compactor actuator 480.

FIGS. 27-28 depict a preferred configuration of the compactor actuator480. The actuator 480 preferably comprises a unitary member having agenerally longitudinal handle 481 and a generally lateral guide rib 483.A spring member 485 extends laterally across an opening formed in theupper surface of the compactor actuator 480, and forms a spring tab 487on its free end. Extending generally upward from the upper surface ofthe compactor actuator 480 are a number of guide projections 489, theupper ends of which are disposed within corresponding compactor guides482 (see FIG. 22) formed on the inward upper surface of the upperhousing 402. In the depicted embodiment, each of the compactor guides482 comprises a generally longitudinal slot 484 and a generally lateralslot 486 which are joined in an “L” configuration. The lateral slot(s)486 may extend purely laterally, or (in the depicted embodiment) theymay be angled slightly forward, forming an angle of slightly more than90 degrees with the corresponding longitudinal slot(s) 484.

Thus, the compactor actuator 480 is employed to move and guide the upperlens compactor 440 along a range of motion (similar to that of the upperlens compactor 240 of the apparatus 200) between a home position, firstcompacted position and second compacted position. At the home position,the upper lens compactor 440 is rearwardly disposed on the ribs 470,472, with the first upper bearing surface 460 resting on the first lowerbearing surface 466 and straddling a gap 474 formed in the surface466/rib 470, and with the second upper bearing surface 462 resting onthe second lower bearing surface 468. In one embodiment, the rearwardedges of the surfaces 460 and 466 (and/or those of the surfaces 462 and468) are aligned when the upper lens compactor 440 is in the homeposition.

From the home position, the actuator 480 and compactor 440 can be movedlongitudinally forward by appropriate manipulation of the handle 481, tothe first compacted position in which the first upper bearing surface460 may remain on the first lower bearing surface 466, but forward ofthe gap 474, and the second upper bearing surface 462 is displacedforward of, and no longer rests on, the second lower bearing surface468. In addition, the lateral guide rib 483 is longitudinally alignedwith or forward of the gap 474, thereby permitting (subsequent) inwardlateral movement of the actuator 480 and compactor 440, and the guideprojections 489 are disposed at the forward ends of the longitudinalslots 484 of the corresponding compactor guides 482 (see FIG. 22). Thefirst compacted position is, in one embodiment, further characterized byrelative situation of the compactors 410, 440, bearing faces 412, 442,channels 414, 444, edges 418, 448, etc. in a manner similar to thatdepicted in FIGS. 16-17 with regard to the apparatus 200. In anotherembodiment, the first compacted position is still further characterizedby contact between a forward edge of the upper lens compactor 440 and astop member 476 formed on the lower housing 404.

From the first compacted position, the actuator 480 and compactor 440can be moved generally laterally inward to the second compactedposition. The second compacted position is, in one embodiment,characterized by relative situation of the compactors 410, 440, bearingfaces 412, 442, channels 414, 444, edges 418, 448, etc. similar to thatdepicted in FIG. 18 with regard to the apparatus 200. As the compactor440 and actuator 480 advance laterally inward, their motion is guided bythe interaction of the guide projections 489 and the lateral slots 486of the corresponding compactor guides 482, until the second compactedposition is reached. In addition, the lateral guide rib 483 moveslaterally into the housings 402, 404 through the gap 474. In oneembodiment, the spring member 485 and spring tab 487 of the actuator 480move sufficiently laterally inward to cause the outer edge of the tab487 to engage the inner edge of a locking ridge 488 (see FIG. 22) formedon the upper housing 402. The spring member 485 prevents disengagementof the tab 487 and ridge 488, thereby preventing backward/outwardlateral movement of the actuator 480 and upper lens compactor 440, oncethe second compacted position has been reached. This in turn ensures thecreation of a rigid, stable “cylinder” at the meeting of the upper andlower insertion channels 414, 444 in the second compacted position, anda smooth longitudinal advancement of the compacted IOL from the“cylinder” into the delivery probe 406. Where employed, the springmember 485, tab 487 and ridge 488 also cooperate to make the apparatus400 a single-use device, ensuring that factory-controlled standards forsterility, suitability of IOL type, etc. may be enforced with respect toeach use of an apparatus 400.

With further reference to FIGS. 21-22, the apparatus 400 furthercomprises a generally cylindrical driving member 490 which is disposedalong the delivery axis A-A. (Where the delivery lumen 408 has an ovalcross-section, the driving member 490 may have a similarly ovalcross-section.) The rearward end of the driving member 490 is receivedin a plunger 491 which is slidably disposed between the upper and lowerhousings 402, 404. The lower housing 404 forms a driving member guide493 situated on the delivery axis A-A. Via appropriate manipulation ofthe plunger 491, the driving member 490 is longitudinally moveable froma retracted position (shown in FIG. 23), in which the forward end of thedriving member 490 is situated in the driving member guide 493, forwardthrough the lower insertion channel 414 (or between the insertionchannels 414, 444 when the upper lens compactor 440 is in the secondcompacted position), thereby urging the IOL 120 forward and into thedelivery lumen 408 of the delivery probe 406. Further advancement of thedriving member will then extrude the IOL from the forward end of thedelivery probe 406.

A spring 495, washer 497 and O-ring 499 may be situated surrounding thedriving member 490 between the driving member guide 493 and the plunger491. In addition, finger grips 501 may be provided on the upper and/orlower housings 402, 404 to facilitate holding the apparatus 400 betweenthe thumb and forefingers, in a “syringe” fashion, with the thumb on therear of the plunger 491 and one forefinger on each of the finger grips501. This arrangement likewise facilitates single-handed operation ofthe apparatus 400 when delivering/inserting an IOL situated in the lowerinsertion channel 414. The spring 495 provides resistance and tactilefeedback when a user is urging the driving member 490 forward with theplunger 491; if desired, the spring 495 and plunger 491 may be sized toreach an abutting relation (and thereby provide thisresistance/feedback) once the forward end of the plunger 491 has enteredthe delivery lumen 408.

Accordingly, the apparatus 400 may be employed to deliver or insert anIOL, such as the IOL 120, into an eye, such as a human eye. In doing so,the user/physician first accesses an insertion location (e.g., thecapsular bag, anterior chamber, etc) within the eye via any suitabletechnique, for example, by making a small incision or series of smallincisions in the anterior structures of the eye. If necessary, thenatural crystalline lens is removed via a suitable technique such asphacoemulsification. Through the incision(s) the physician inserts theforward end of the delivery probe 406, preferably after compacting theIOL as detailed above and, if desired, after advancing the IOL partwaythrough the lumen 408 of the delivery probe 406. With the end of thedelivery probe in place, the physician extrudes the IOL from the probe406, thereby inserting the IOL in the eye. (By employing the apparatus400, the compacting and delivery/insertion may be done without openingthe housing 402/404 or otherwise manually accessing the IOL.) Upondeparture from the probe 406, the IOL “un-compacts” by virtue of itselasticity, returning substantially to its unstressed condition. Thephysician then withdraws the probe 406 and, if necessary, adjusts thepositioning of the IOL within the eye. Upon satisfactory positioning ofthe IOL, the physician closes the incision(s) to complete the operation.

Various embodiments of the apparatus 200/400 disclosed hereinadvantageously facilitate delivery of an IOL into the eye of a patientwithout need for a physician to handle the IOL or manually load it intoan insertion device. For example, the IOL may be positioned within thelens compactor (e.g., between the upper and lower lens compactors) ofthe apparatus 200/400 during manufacture/assembly of the apparatus. Theapparatus 200/400, with the IOL thus disposed inside the lens compactor,may then be sterilized as a unit, either at the point of manufacture orat some downstream location. Where appropriate, the sterilizedapparatus-IOL assembly may be contained in a sterile package, wrapper,bag, envelope, etc. in which the apparatus-IOL assembly may remain untilarrival at the point (or time) of use. (The apparatus-IOL assembly maybe sterilized before and/or after placement in the package, etc.) Thisfurther facilitates a simple point-of-use procedure for medicalpersonnel involved in implanting the IOL contained in the apparatus200/400: after opening (any) packaging, the physician, or other medicalpersonnel, can compact and insert the IOL using the apparatus 200/400 asdiscussed above, without (any need for) removing the IOL from theapparatus. Accordingly, there is no need to handle the IOL or manuallyload it into an insertion device at the point of use, both of which canbe difficult and tedious, and can compromise the sterility of the IOL.

FIGS. 30-32 depict alternative structures that may be employed inconnection with one or both of the lower and upper engagement faces212/412, 242/442, instead of or in addition to the generally flatsurfaces described above. For example, FIG. 31 depicts the use of one ormore pockets 550, 552 formed in the faces 212/412, 242/442. The pockets550, 552 may be suitably shaped (e.g. as partial, substantiallycylindrical or spherical shells, or with a rectangular or otherpolygonal profile) to grip the respective viewing elements 124, 122. Ina further embodiment, the pocket(s) 550, 552 may be formed from amaterial, such as any of the materials discussed above, having anadhesive affinity for the material(s) employed to construct the outerfaces of the viewing elements.

As seen in FIGS. 31-32, vacuum grips 560, 562 may be employed inconnection with the engagement face(s) 212/412, 242/442. In the depictedembodiment, each vacuum grip 560, 562 comprises a domelike button 564enclosing a vacuum chamber 566 in fluid communication with a reliefopening 568 formed in the respective engagement face(s) 212/412, 242/442which is positioned to abut the respective viewing element(s) 124, 122.Thus, depression of the button(s) 564 expels air from the reliefopenings 568, and the resilient properties of the button(s) 564 aresufficient to urge the button(s) 564 toward their original position. Thenegative pressure thereby created in the vacuum chamber(s) 566 draws theviewing element(s) 124, 122 against the engagement face(s) 212/412,242/442. With the viewing elements so gripped, the compactors 210/410,240/440 may be relatively moved to place the IOL 120 in the firstcompacted configuration shown in FIG. 32.

As yet another alternative, one or both of the engagement face 212/412,242/442 may be suitably roughened to engage the viewing elements 122,124. Such surface roughening may be employed on its own, or inconnection with any of the alternatives discussed herein forconstructing the engagement face 212/412, 242/442. In one embodiment,the surfaces in question are sanded; as one example, 100 grit sandpapermay be employed. In other embodiments, the surfaces may be ribbed,knurled, etc.

In further embodiments of the apparatus 200/400, the lower housing204/404, lower lens compactor 210/410 and/or upper lens compactor240/440 may be configured such that the upper lens compactor 210/410 ismoveable only from the first compacted position to the second compactedposition. In other words, the first compacted position replaces the homeposition as the “start” location of the upper lens compactor 240/440,which can move from the first compacted position to the second compactedposition in the manner already described. Any or all of the structuresdescribed above as facilitating longitudinal movement of the upper lenscompactor 210 between the home and first compacted positions may beomitted, if desired. The balance of the structure and function of theapparatus 200/400 preferably remains as described above.

Such a modified apparatus 200/400 is particularly useful for compactingand/or inserting a single-lens IOL, such as (but not limited to) the IOL100 described above. Alternatively, a multiple-lens IOL, such as (butnot limited to) the IOL 120 described above, may be compacted and/orinserted with this modified apparatus. In one embodiment, themultiple-lens IOL is disposed or stored in the compactor in the firstcompacted condition described above, when the upper lens compactor is inthe first compacted position (again, the “start” location of the upperlens compactor). In another embodiment, the multiple-lens IOL isdisposed or stored in the compactor in the substantially unstressedcondition described above, when the upper lens compactor is in the firstcompacted position.

FIGS. 33-44 depict an embodiment of an injector 600 for injecting an IOL700 into the eye of a patient. In one embodiment, the IOL 700 comprisesan accommodating intraocular lens having two or more interconnectedviewing elements or two or more interconnected optics. One, both or allof the viewing elements of the IOL 700 may comprise an optic or lenshaving refractive (or diffractive) power. Alternatively, one, both orall of the viewing elements may comprise an optic with a surrounding orpartially surrounding perimeter frame member or members, with some orall of the interconnecting members attached to the frame member(s). As afurther alternative, one of the viewing elements may comprise aperimeter frame with an open/empty central portion or void located onthe optical axis, or a perimeter frame member or members with azero-power lens or transparent member therein. In still furthervariations, one of the viewing elements may comprise only a zero-powerlens or transparent member.

In another embodiment, the IOL 700 may comprise any of the variousembodiments of accommodating intraocular lenses described in U.S. Pat.No. 7,198,640, issued on Apr. 3, 2007, titled ACCOMMODATING INTRAOCULARLENS SYSTEM WITH SEPARATION MEMBER, or any of the various embodiments ofaccommodating intraocular lenses described in U.S. Patent ApplicationPublication No. 2005/0234547, published Oct. 20, 2005, titledINTRAOCULAR LENS. The entire disclosures of the above-mentionedpublications are hereby incorporated by reference herein and made a partof this specification. In still other embodiments, the IOL 700 maycomprise a single-optic system, of the accommodating ornon-accommodating type.

In one embodiment, where the IOL 700 comprises a dual-optic system (or,more generally, a dual-viewing-element system), the injector 600manipulates the IOL 700 in two stages while moving the IOL 700 along asingle axis, specifically a longitudinal axis A-A of the injector 600.(The longitudinal axis A-A is also referred to herein as an “injectionaxis” of the injector.) In a first stage of manipulation, the injector600 displaces first and second optics 702, 704 of the IOL 700 into anon-coaxial relation (see FIGS. 34, 38), in which the optical axes B-B,C-C of the first and second optics 702, 704 are displaced relative toeach other. Displacing the optics 702, 704 and their respective opticalaxes in this manner reduces the overall thickness of the IOL 700. In asecond stage of manipulation, the injector 600 compacts, folds orcrushes the (thus-displaced) IOL 700 into an injection channel 635 (seeFIGS. 35, 36, 40) oriented along the injection axis A-A of the injector600.

In one embodiment, the first optic 702 comprises an anterior optic andthe second optic 704 comprises a posterior optic. The terms “anterior”and “posterior” are derived from the positions preferably assumed by theoptics 702, 704 upon implantation of the IOL 700 into an eye.

The injector 600 generally comprises a housing 602 and an actuator/lenscarrier or “sled” 604 slidably mounted on the housing 600. The IOL 700is (initially) stored in the housing 602 in a home position, in asubstantially unstressed storage condition (see FIG. 33; also known as a“neutral” or “packaged” condition). In the storage condition the optics702, 704 are arranged substantially coaxially, with their respectiveoptical axes B-B, C-C substantially aligned or collinear, and with theiroptical axes B-B, C-C oriented substantially orthogonal to thelongitudinal axis A-A of the injector 600/housing 602. As the useradvances the actuator 604 distally or forward along the housing,actuator pins 606, 608 formed on the actuator 604 (see FIG. 39)simultaneously advance forward in slots 610, 612 formed in the bottom ofthe housing 602. Because the pins 606, 608 protrude through the slots610, 612 and engage one of the viewing elements of the IOL 700, theforward advance of the pins 606, 608 urges the IOL 700 forward ordistally within the housing, generally along the slots 610, 612 andalong the longitudinal axis A-A.

As the IOL 700 is advanced forward, the first optic 702 comes intocontact with an inclined portion or ramp portion 620 of the housing 602(see FIG. 38). The inclined portion 620 forces the first optic 702 tomove rearward and downward relative to the advancing second optic 704.Thus the first optic 702 falls behind the advancing second optic 704,urging the optics 702, 704 into a flatter, non-coaxial “displaced”condition as shown in FIGS. 34 and 38. As seen in FIG. 34, the optics702, 704 preferably remain disposed substantially along the longitudinalaxis A-A of the injector 600/housing 602 when the IOL 700 is in thedisplaced condition shown in FIGS. 34 and 38. In one embodiment, theoptics 702, 704 of the IOL 700 are relatively displaced into a conditionin which the optics do not “overlap” at all, as viewed along the opticalaxis of either optic. In still another embodiment, the optics 702, 704are relatively displaced until the optics 702, 704 are in substantiallyplanar, side-by-side alignment (either overlapping or non-overlapping)such that the thickness of the IOL 700 is minimized.

The inclined portion 620 may be considered one type of “single-elementengagement surface” as it is one of a variety of suitable structureswhich may be employed to engage one, but not the other, of the viewingelements of a two-viewing-element IOL 700 as the IOL 700 advancesdistally through the injector housing 602.

After the optics 702, 704 have been relatively displaced as shown inFIG. 38, the IOL 700 and actuator 604 may be further advanced until theIOL 700 is situated between a pair of compacting members or wedge plates630, 632 (see FIG. 34). Tabs 634, 636 formed on the actuator 604 (andextending through slots 638, 639 formed on the sides of the housing 602,upon sufficient advancement of the actuator 604) engage the compactingmembers 630, 632 and urge the members 630, 632 forward along with theIOL 700 and actuator 604.

As the compacting members 630, 632 move forward, they converge on theIOL 700, due to the tapered configuration of the members' outer edgesand the housing 602. Each of the compacting members 630, 632 forms acorresponding face 631, 633 in the form of a half-channel on its inneredge (see FIG. 40). Consequently, the converging faces 631, 633 compact,crush and/or fold the IOL 700 (which is preferably urged into the“displaced” condition shown in FIGS. 34 and 38 before compacting) in theinjection channel 635, which is formed at the meeting of the two members630, 632 once the members have been driven all the way forward. Theinjection channel 635 thus formed is substantially aligned on theinjection axis A-A with an injection probe or nozzle 640 formed by thehousing 602, and a plunger 642. This injection channel 635, whichpreferably has a cross-section which substantially matches that of aninner lumen of the injector probe 640, holds the folded/crushed anddisplaced IOL 700 ready for further distal longitudinal movement intothe injector probe 642.

When the compacting members 630, 632 have reached theforwardmost/distalmost position just described and shown in FIG. 35, themembers 630, 632 will have converged (and moved laterally) sufficientlyfor the tabs 634, 636 of the advancing lens carrier 104 to clear anddisengage from the rearward surfaces of the members 630, 632. The lenscarrier 604 may thus be further advanced distally, detached from thehousing 602 and discarded (see FIG. 38).

As seen in FIG. 41, the housing 602 preferably forms a disengagementramp 680 on its underside. The ramp 680 is positioned to force the pins606, 608 of the lens carrier 604 to move downward and disengage from theIOL 700 (and, if desired, disengage from the slots 610, 612) as the IOL700 moves between the compacting members 630, 632. The lens carrierpreferably forms a flexible pin tab 682 (see FIGS. 36, 39) which isconfigured to contact the ramp 680 upon sufficiently distal movement ofthe lens carrier 604, and flex downward under the urging of the ramp680, thus disengaging the pins 606, 608 as discussed above.

Once the compacting members 630, 632 have folded or compacted the IOL700, application of pressure to the plunger 642 drives the tip 643 ofthe plunger forward, into the injection channel 635 between the plates630, 632 and against the “crushed” or “folded” IOL 700 disposedtherebetween (see FIG. 37). With continued application of pressure, theplunger 642 urges the IOL 700 into the inner lumen of the probe 640. Theend of the probe 640 may be inserted into the eye of a patient in thetypical manner, for delivery of the IOL 700 from the tip of the probe.

As seen in FIG. 44, each of the compacting members 630, 632 may includea lead-in 650 at the rearward or proximal end of the corresponding face631, 633 to ensure that the tip 643 of the plunger 642 is easilyinserted between the converged compacting members 630, 632.

FIGS. 45-47 depict another embodiment of the injector 600, which can besimilar to the embodiment of FIGS. 33-44, except as further describedand depicted herein. In this embodiment, the actuator/lens carrier 604may comprise a thin elongate member or strip formed from a suitablepolymer film (e.g., PET film). When the IOL 700 is in the storageposition (see FIG. 46), the first optic 702 rests on the actuator 604,and the second optic 704 is in contact with the adjacent wall of thehousing 602. The actuator 604 is then drawn forward through the tip ofthe probe 640, and the actuator in turn pulls the IOL 700 forward,causing displacement of the optics into a non-coaxial condition asdescribed above (see FIG. 47). Once the IOL 700 has been drawn betweenthe compacting members 630, 632, the members may be converged byapplying pressure to handles 660, 662 formed thereon. (Accordingly, thehandles 160, 162 comprise an alternative (or supplement) to the actuatortabs 634, 636 discussed above.) With the lens 200 fully compacted, theplunger 642 may be employed in the usual manner, to push the lensthrough the injection channel 635 and out the tip of the probe 640.

Accordingly, in the embodiments of FIGS. 33-44 and 45-47, both the lenscarrier 604 and the IOL 700 are moved longitudinally, along acontinuously longitudinal path, from a first or home position (FIG. 33)in which the lens carrier 604 engages the lens 200 and the optical axesB-B, C-C of the viewing elements or optics 702, 704 are substantiallyaligned, to a second position (FIG. 35) in which one of the viewingelements/optics is forward of the other and the viewing elements/opticsare at least partially compacted. The continuously longitudinal path is,in these embodiments, generally coincident with the longitudinal axis orinjection axis A-A. The continuously longitudinal path extends distallyfrom the home position, past the single-element engagement surface 620located distal of the home position, and between the opposedlens-compacting surfaces of the compacting members 630, 632, which arelocated distal of the single-element engagement surface 620.

The lens carrier 604 and the IOL 700 are moved further longitudinally,along the continuously longitudinal path, from the second position to athird position in which the (displaced and compacted) IOL 700 issituated within the injector probe 642. From the third position, the IOL700 is urged longitudinally, along the continuously longitudinal path,out the distal tip of the probe 642.

FIG. 48 depicts another embodiment of the injector 600, which can besimilar to the embodiments of FIGS. 33-44 or 45-47, except as furtherdescribed and depicted herein. In the injector 100 of FIG. 48, the lens200 is configured to move distally, along a continuously longitudinalpath in which only a distal portion 802 thereof is substantiallycoincident with the longitudinal axis/injection axis A-A. Operation ofthe lens carrier 604 moves the lens distally and along an upslope 804,whereupon the first optic 702 contacts the single-element engagementsurface 620. The surface 620 causes the first optic 702 to fall behindthe second optic 704, thus displacing the IOL 700 as described anddepicted above. Once past the upslope 804, the displaced IOL 700proceeds distally, substantially along the longitudinal axis A-A, untilthe IOL 700 reaches the compacting members (not shown in FIG. 48). Thecompacting and injection process then continues in the manner describedand depicted above.

It is contemplated that the IOL 700 may be positioned within (any of theembodiments of) the injector 600 (e.g., with the lens in the storagecondition) during manufacture/assembly of the injector. The injector600, with the IOL 700 thus disposed inside, may then be sterilized as aunit, either at the point of manufacture or at some downstream location.Where appropriate, the sterilized injector-lens assembly may becontained in a sterile package, wrapper, bag, envelope, etc. in whichthe injector-lens assembly may remain until arrival at the point (ortime) of use. (The injector-lens assembly may be sterilized beforeand/or after placement in the package, etc.) This facilitates a simplepoint-of-use procedure for medical personnel involved in implanting theIOL 700 contained in the injector 100: after opening (any) packaging,the physician, or other medical personnel, can compact and insert theIOL 700 using the injector 600 as discussed above, without (any needfor) removing the IOL 700 from the injector 600. Accordingly, there isno need to handle the IOL 700 or manually load it into an insertiondevice at the point of use, both of which can be difficult and tedious,and can compromise the sterility of the lens.

Except as further described herein, any of the embodiments shown inFIGS. 33-48 may be similar to any of the embodiments disclosed in FIGS.3-32.

In some instances, it can be desirable to provide a tactile feel ortactile feedback to a user of an injector to indicate that an IOL isnearing a distal tip of the injector. This tactile feedback can allowthe user to more carefully and controllably advance the IOL through adistal opening of the injector into an eye. In some embodiments, thetactile feedback is provided when the IOL and/or a plunger moving theIOL advances through an area having a higher coefficient of friction. Insome embodiments, such an area is located in a distal or terminal regionof the injector.

In further instances, it can be desirable to control the direction,orientation, and/or speed at which an IOL is delivered from an injector.In some embodiments, an area having a higher coefficient of friction isprovided at the distal end of injector to slow egress of the IOL andthus provide a user with greater control over delivery of the IOL. Thehigher coefficient of friction can counteract a driving force providedto the IOL by the user of the injector and/or a driving force providedby the IOL itself, such as can arise from the release of stored energyas the IOL transitions from a compressed configuration within theinjector to a relaxed configuration outside of the injector. In someembodiments, an expandable member is included at a distal end of theinjector to absorb at least a portion of the energy released by the IOLwhen it transitions from the compressed configuration to the relaxedconfiguration, thereby slowing egress of the IOL.

FIG. 49 depicts an embodiment of an injector 900 (which may include, butis not limited to, the apparatus 200, the apparatus 400, or the injector600). In certain embodiments, a frictional force generated during use ofthe injector 900 provides tactile feedback to a user indicating that anIOL 930 moving within the injector 900 is nearing the position where itwill leave the injector 900. In some embodiments, a frictional forceslows the egress of the IOL 930 from an opening 917 at a distal end ofthe injector 900, which can permit relatively controlled delivery of theIOL 930 to an eye.

The injector 900 can include a conduit, conveyance, channel, tube,tubular member, or tubular section 902 that defines a lumen 910 (whichmay be, but is not limited to, a lumen within the delivery probe 406 orthe injector probe 640) having a terminal portion 912 at a distal end916 and a proximal portion 914 located proximal to, and juxtaposed with,the terminal portion 912. The distal end 916 of the lumen 910 can definethe opening 917 through which an IOL 930 can pass to be delivered withinan eye. The lumen 910 can further include an inner surface 918. Thetubular section 902 can comprise an outer surface 919.

In some embodiments, the injector 900 further includes an injectorplunger 920 (which may include, but is not limited to, the drivingmember 290, the driving member 490, or the plunger 642) that is at leastpartially disposed within the lumen 910. The injector plunger 920 canimpart a driving force on the IOL 930 which moves the IOL 930 within thelumen 910. The IOL 930 may be a single-, dual-, or multiple-opticintraocular lens, including, but not limited to, the IOL 100, themultiple-lens IOL 120, and the IOL 700, referenced above. Duringinjection, the injector plunger 920 is moved towards the distal end 916of the lumen 910, which in turn causes the IOL 930 to move towards thedistal end or distal tip 916. Along its journey through the lumen 910,the IOL 930 moves through the proximal portion 914 of the lumen 910before passing through the terminal portion 912.

In some embodiments, the IOL 930 is conveyed along the tubular section902 in a compacted condition. Any suitable orientation of the IOL 930 inthe tubular section 902 could be provided. In some embodiments, the IOL930 comprises two or more optics, and can be advanced through thetubular section 902 with one optic in front of another optic. Forexample, in some embodiments, a first viewing element (such as theviewing element 702) is in front of a second viewing element (such asthe viewing element 704) as the IOL 930 is advanced through the tubularsection 902, and in other embodiments, the second viewing element is infront of the first viewing element. In some embodiments, the IOL 930 ismore compacted in at least one phase of injection, e.g., within thetubular section 902, than is shown in the illustrated embodiments. Forexample, one or more optics may be folded or rolled, as described above.This further compaction of the optic(s) can enable insertion through asmaller incision.

With reference to FIGS. 49 and 50, the movement of the IOL 930 throughthe lumen 910 creates a lens coefficient of friction 940 between theinner surface 918 and the abutting surface of the IOL 930, the lenscoefficient of friction being associated with a lens frictional force942 that acts on the IOL 930 and that resists the driving force 944imparted on the IOL 930 by the injector plunger 920. The higher thecoefficient of sliding friction, μ, between the two surfaces, thegreater the frictional force, F, associated with one surface slidingpast the other. Quantitatively, F=μ N, where N is the strength of theforce (perpendicular to the interface between the surfaces) that holdsthe two surfaces together. In certain embodiments, the lens frictionalforce 942 has a smaller value when at least a portion of the IOL 930abuts the inner surface 918 at a first location, L₁, located within theproximal portion 914 of the lumen 910, than when at least a portion ofthe IOL 930 abuts the inner surface 918 at a second location, L₂,located within the terminal portion 912.

In certain embodiments, due to the increase in frictional forceexperienced by the IOL 930 between the first location L₁ and the secondlocation L₂ of the lumen 910, the user of the injector 900 is providedwith tactile feedback indicating that the IOL 930 is nearing ejectionfrom the distal end 916 of the lumen 910. In further embodiments, the Lgreater frictional force acting on the IOL 930 substantially preventsthe IOL 930 from springing from the distal tip 916. The greaterfrictional force acting on the IOL 930 within the terminal portion 912can thus provide the user with greater control over the IOL 930 duringejection. Accordingly, in some embodiments, the terminal portion 912 mayalso be referred to as a release control section.

In certain embodiments, the release control section is sized to fitwithin the anterior chamber of an eye when the injector 900 ispositioned in the eye to inject the IOL 930 into the anterior chamber.Accordingly, in some embodiments, the release control section 912resists passage of the IOL 930 through the portion of the injector 900that is located within the anterior chamber.

In some embodiments, the lens frictional force 942 provided by therelease control section 912 resists a restorative force of the IOL 930.For example, as described above, the IOL 930 can be deformed, compacted,or compressed to a relatively small configuration as the IOL 930 isprepared for insertion into an eye via the injector 900. As the IOL 930emerges from the distal end 916 of the injector 900, at least a portionof the IOL 930 can expand to a natural, decompressed, or relaxed state,thereby releasing stored mechanical energy. In some instances, thisrelease of stored energy imparts a driving force to the remainder of theIOL 930 that is located within the injector 900. In some embodiments,the driving or restorative force due to expansion of the IOL 930, or therelease of mechanical energy stored in the compacted IOL 930, can beinhibited, slowed or counteracted by the lens frictional force 942.

In some embodiments, once the injector plunger 920 is advanced distallywithin the lumen 910 sufficiently far to cause a portion of the IOL 930to emerge from the lumen 910, the resulting driving force due to releaseof stored energy is sufficient to cause the IOL 930 to emerge from thelumen 910 without further urging from the plunger 920. For example, insome embodiments, the plunger 920 is advanced to the point where therestorative force of the IOL 930 is sufficient to move the IOL 930 fromthe lumen 910, but is advanced no further than this point, thuspermitting the IOL 930 to egress from the lumen 910 of its own accord.In certain of such embodiments, the lens frictional force 942 may thuscounteract only the driving force supplied by the IOL 930 itself as itemerges from the lumen 910, thereby slowing egress of the IOL 930.

In other embodiments, the plunger 920 can be advanced beyond a pointwhere a restorative force arises as the IOL 930 egresses the lumen, andthus can help urge the IOL 930 out of the lumen 910. Accordingly, insome embodiments, the lens frictional force 942 resists both the drivingforce 944 imparted by the plunger 920 and the driving force imparted bythe release of stored energy from the IOL 930.

In certain embodiments, such as when the IOL 930 includes two or moreoptics, the IOL 930 can store more energy and at least for this reasoncan be more complicated to inject in a controlled manner than can somesingle-optic systems. For example, in some embodiments, the IOL 930includes a first and a second viewing element (such as, for example, theviewing elements 702, 704), and further includes two or more biasingmembers (such as, for example, the biasing members 126, 128) connectingthe viewing elements. Accordingly, the dual-optic IOL 930 can havegreater mass than certain single-optic varieties, and further, caninclude separate masses capable of independent movement relative to oneother that are joined by spring-like members. Providing controlledegress of such an IOL 930 can be particularly important in theenvironment of the delicate structures of the eye.

Certain embodiments described herein can advantageously retard egress ofthe optics of a dual-optic IOL 930 such that the plunger 920 is used tourge both the first and the second optics from the lumen. In someembodiments, the release control section 912 is capable of retaining asecond optic (such as the element 704) stationary after a first optic(such as the element 702) has exited the lumen 910. In certainembodiments, the release control section 912 is configured to retain thesecond optic substantially stationary relative to the injector 900, evenafter a substantial portion of the second optic has exited the lumen910. For example, the substantial portion of the second optic can bebetween about ⅕ and about ½, between about ¼ and about ½, or betweenabout ⅓ and about ½ of the optic. In some embodiments, the portion is noless than about ¼, no less than about ⅓, no less than about ½, or noless than about ⅔ of the optic. Permitting a large portion of the IOL930 to egress the lumen while maintaining at least a portion of a secondoptic of the IOL 930 relatively stationary in this manner can provide anoperator of the injector 900 with excellent control over the deliveryand placement of the IOL 930.

Contact between the IOL 930 and the inner surface 918 of the lumen 910can create a lens coefficient of friction 940 that varies as the IOL 930moves through the lumen 910. FIGS. 51A, 51B, and 51C display threeprofiles illustrating possible manners in which the lens coefficient offriction 940 can be varied in the injector 900. In some embodiments, thefrictional force 942 acting on the IOL 930 between the locations L₁ andL₂ also follows the profiles shown in FIGS. 51A-C.

In FIG. 51A, the lens coefficient of friction 940 acting on the IOL 930increases in a substantially linear fashion as the IOL 930 moves fromthe location L₁ to the location L₂. In some embodiments, the increase inthe coefficient of friction 940 is relatively gradual, moderate,regular, or steady. For example, in some embodiments, the slope of theline depicted in FIG. 51A can be relatively small. In other embodiments,the increase in the coefficient of friction 940 is relatively strong orpronounced. For example, in some embodiments, the slope of the linedepicted in FIG. 51A can be relatively large.

In FIG. 51B, the lens coefficient of friction 940 is relatively constantbetween the location L₁ and a transition point between the locations L₁and L₂ at which the coefficient of friction 940 increases abruptly orsuddenly. The coefficient of friction 940 is at a substantiallyconstant, higher value between the transition point and the location L₂.

In FIG. 51C, the lens coefficient of friction 940 varies in a non-linearfashion between the locations L₁ and L₂ such that the coefficient ishigher at the location L₂ than at the location L₁. In each of theforegoing embodiments, the lens coefficient of friction 940 and thecorresponding frictional force 942 acting on the IOL 930 each increasesas the IOL 930 approaches the distal end 916 of the lumen 910. Otherprofiles of the lens coefficient of friction 940 and the correspondingfrictional force 942 acting on the IOL 930 between the locations L₁ andL₂ are also possible.

In certain embodiments, the inner surface 918 of the lumen 910 creates alens coefficient of friction 940 with the IOL 930 that causes the lensfrictional force 942 to increase as the IOL 930 egresses the lumen 910.For example, the lens coefficient of friction 940 can increase withinthe terminal portion 912 such that the associated lens frictional force942 increases as the IOL 930 egresses the lumen 910. Any suitabletechnique may be used to control the lens coefficient of friction 940between the IOL 930 and the inner surface 918.

With reference to FIG. 52, in some embodiments, the lens coefficient offriction 940 is caused at least in part by one or more coatings 950selectively covering the inner surface 918 of the lumen 910. In someembodiments, a low-friction coating 950 substantially covers the entireinner surface 918 of the proximal portion 914 of the lumen 910. In someembodiments, a low friction coating 950 covers only a portion of theinner surface 918 of the terminal portion 912 of the lumen 910. Thecombination of coated and uncoated regions of the inner surface 918 ofthe terminal portion 912 can provide a higher coefficient of friction atthe second location L₂ as compared with the first location L₁.

In certain embodiments, when the proximal portion 914 is substantiallyentirely covered with the low-friction coating 950 and the terminalportion 912 is only partially coated with the coating 950, the terminalportion 912 can substantially retard egress of the IOL 930 from theinjector 900. Advantageously, in some embodiments, presence of thelow-friction coating 950 at the terminal portion 912 provides sufficientlubricity to deliver the IOL 930 substantially without causing harm tothe IOL 930. Retarding egress of the IOL 930 in this manner thus canpermit more controlled injection of the IOL 930 without scratching ormarring the IOL 930, without leaving a film or residue on the IOL 930,and/or without otherwise detrimentally affecting operation of the IOL930.

The low-friction coating 950 can be of any suitable variety. In someembodiments, the coating 950 is adhered to, deposited on, or otherwiseapplied to the inner surface 918. In other embodiments, the coating 950is integrally formed with the material that defines the lumen 910. Thecoating 950 is preferably configured to not scratch, mar, or otherwisedamage the IOL 930. In some embodiments, the coating 950 is hydrophilic.In various embodiments, the coating may comprise hydrophilic materialsthat are either directly or indirectly adhered, bonded, mechanicallylocked or otherwise attached to or coupled with the material that formsthe inner lumen 910. The hydrophilic material may be a two partpolymeric coating comprising a supporting polymer and a hydrophilicpolymer. The supporting polymer may be cross-linked polyacrylate thatmay be attached to the inner surface 918 of the lumen 910.

As indicated above, the inner surface 918 can include partially coatedsurfaces that include alternating zones of coated surface and uncoatedsurface, or that define an arrangement of coated portions separated byuncoated portions. In the illustrated embodiment, the coating 950defines a series of rounded or circular segments 952 that are separatedby an uncoated portion of the inner surface 918 of the terminal portion912 of the lumen 910. The segments 952 can define shapes orconfigurations other than circles, such as, for example, polygons orsubstantially irregular shapes. In some embodiments, one or more of thesegments 952 are sized differently from other segments 952.

The coated and uncoated surfaces can form a variety of otherarrangements or patterns. For example, in some embodiments, at least oneof the partially coated surfaces includes a checkerboard or crosshatchpattern of coated surface and uncoated surface. Some patterns orarrangements can be regular or repeated, and others can be substantiallyirregular. For example, in some embodiments, the arrangement of coatedand uncoated surfaces substantially defines a spray pattern or a zigzagpattern, and in other embodiments, the coated and uncoated surfaces arearranged randomly, irregularly, or without a repeated pattern. The sizeand configuration of a pattern can be optimized to provide a desiredamount of slowing to the egress of the IOL 930.

In some embodiments, the partially coated surface extends from a distaledge of the lumen 910 to a position within the lumen only a relativelyshort distance from the distal edge of the lumen 910. In variousembodiments, the distance is between about 1.0 centimeters and about 5.0centimeters, between about 0.5 centimeters and about 4.0 centimeters,between about 0.1 centimeters and about 3.0 centimeters, or betweenabout 0.1 and about 1.0 centimeter. In some embodiments, the distance isno more than about: 0.1 centimeters, 0.25 centimeters, 0.5 centimetersor 1.0 centimeters. As with other properties of the partially coatedsurface, the distance from the distal edge of the lumen 910 to which thepartially coated surface extends can be optimized to provide a desiredamount of slowing to the IOL 930.

In some embodiments, the inner surface 918 includes a low-frictioncoating surface at the first location, L₁, and an uncoated surface atthe second location, L₂. In other embodiments, the inner surface 918includes a high-friction coating surface at the second location, L₂, andan uncoated surface at the first location, L₁. In still otherembodiments, the inner surface 918 includes a low-friction coatingsurface at the first location, L₁, and a high-friction coating surfaceat the second location, L₂. In some embodiments, the inner surfaceincludes a partially coated surface at one or both of the first andsecond locations, L₁, L₂. In some embodiments, the second location L₂(whether coated or uncoated) is roughened such that the coefficient offriction at the second location L₂ is greater than the coefficient offriction at the first location L₁.

In some embodiments, the inner surface 918 has a greater proportion ofits area coated with a low-friction coating at the first location L₁than at the second location L₂. In certain of such embodiments, theinner surface 918 can be completely coated or partially coated with thelow-friction coating at the first location L₁, and/or the inner surface918 can be partially coated with the low-friction coating or uncoated atthe second location L₂.

With reference to FIG. 53, in certain embodiments, the lens coefficientof friction 940 is provided at least in part by one or more channels,indentations, depressions, or grooves 954 in the inner surface 918 ofthe terminal portion 912 of the lumen 910. The grooves 954 can be formedin any suitable manner, such as by molding, milling, or etching. In someembodiments, the grooves 954 are laser etched into the inner surface918. In various embodiments, one or more of the grooves 954 has a depth,as measured in a direction substantially orthogonal to a straightsurface line along a longitudinal length of the inner surface 918, of nomore than about 0.0005 inch to about 0.003 inch. In other embodiments,the depth, as measured in a direction substantially orthogonal to astraight surface line along a longitudinal length of the inner surface918, of about 0.0005 inch to about 0.002 inch. In some embodiments, oneor more of the grooves 954 has a width, or a minimal separation distanceof opposite sides of a groove 954, of no more than about 0.001 inch toabout 0.100 inch or more preferably from about 0.001 inch to about 0.050inch. Values outside of the listed ranges are also possible.

In the illustrated embodiment, the grooves 954 are substantiallyzigzagged. Zigzag grooves also can be substantially parallel to eachother. The length of the grooves 954 increases toward the distal tip 916of the lumen 910, thus the grooves 954 generally define a triangulargrooved region 955 in one embodiment. The coefficient of friction canincrease from a proximal tip of the grooved region 955 to a distal baseof the grooved region 955, thus resulting in a coefficient of frictionprofile, such as that illustrated in FIG. 51A. This figure illustratesthat in some embodiments, at least a portion of the coefficient offriction profile can increase linearly. Other arrangements are possiblefor grooves 954 and/or the grooved region 955. For example, in someembodiments, the grooved region 955 defines a generally parabolic,generally semicircular, or generally polygonal (e.g., square orrectangular) perimeter.

FIG. 54 illustrates another embodiment of the injector 900. The injector900 can define an angled tip 956 that includes a grooved region 955. Insome advantageous embodiments, the angled tip 956 provides for arelatively controlled egress of the IOL 930 from the distal end 916 ofthe lumen 910. For example, in some embodiments, a portion of the IOL930 expands from an open region 957 substantially opposite the groovedregion 955. As a portion of the IOL 930 expands through the open region957, energy is released that tends to move the IOL 930 distally from thelumen 910. However, in some embodiments, a portion of the IOL 930opposite the expanding portion is in contact with the grooved region955, which can have a relatively large coefficient of friction and thustend to slow and/or control egress of the IOL 930.

In some embodiments, the angled tip 956 can more easily or moreeffectively be laser etched than certain flat-tipped embodiments. Forexample, the open region 957 can provide an optical path that isunobstructed by the lumen 910 and, in further instances, that issubstantially orthogonal to the inner surface 918.

With reference to FIGS. 54B-54D, the grooves 954 within the groovedregion 955 can define a variety of patterns. As shown in FIG. 54B, insome embodiments, at least some of the grooves 954 are substantiallysemicircular. As shown in FIG. 54C at least some of the grooves 954 canbe substantially rectangular, and can be elongated in a directionsubstantially parallel to a longitudinal length of the lumen 910. Thoughillustrated as substantially rectangular, the groves can have varyinglengths providing a generally triangular or distally expanding area. Asshown in FIG. 54D, at least some of the grooves 954 can be elongated ina direction substantially perpendicular to a longitudinal length of thelumen 910. Other arrangements of the grooves 954 and the grooved region955 are also possible. For example, the grooves 954 can be substantiallyovoid and/or can have rounded edges. The grooved region 955 can define ashape other than substantially triangular, and can extend over a largeror smaller portion of the inner surface 918 than that shown in FIGS.54B-54D.

In some embodiments, the inner surface 918 of the lumen 910 includesraised portions or protrusions (not shown) in addition to or instead ofthe grooves 954. In some embodiments, the raised protrusions arerelative to each other, sized, and/or shaped in the same manner as thegrooves 954 illustrated in any of FIGS. 53 and 54A-D. For example, insome embodiments, the protrusions have a height, as measured from theinner surface 918, that is within the ranges described above withrespect to the grooves 954. The protrusions can be arranged in any ofthe manners described with respect to the grooves 954.

FIG. 55 depicts another embodiment of the injector 900 in which africtional force can be used to provide tactile feedback to a user toindicate that an intraocular lens moving within the injector is nearingthe position where it will leave the injector. The injector 900 includesa lumen 960 having a terminal portion 962 at a distal end 966 and aproximal portion 964 located proximal to, and juxtaposed with, theterminal portion 962. The lumen 960 further includes an inner surface968.

In certain embodiments, the injector 900 further includes an injectorplunger 970 at least partially disposed within the lumen 960. Theinjector plunger 970 includes an abutting surface 972 in facingarrangement to, and in at least temporary contact with, the innersurface 968 of the lumen 960. The injector plunger 970 imparts a drivingforce on the IOL 980 which moves it within the lumen 960. The IOL 980may be a single-, dual-, or multiple-optic intraocular lens, including,but not limited to, the IOL 100, the multiple-lens IOL 120, and the IOL700, referenced above. During injection, the injector plunger 970 ismoved towards the distal end 966 of the lumen 960, which in turn causesthe IOL 980 to move towards the distal end 966. Along its journeythrough the lumen 960, the IOL 980 moves through the proximal portion964 of the lumen 960 before passing through the terminal portion 962. Insome embodiments, the abutting surface 972 of the plunger 970 isrelatively closer to the distal end of the plunger 970 than isschematically depicted in FIG. 55. This variation would permit theabutting surface 972 to traverse more than one region of the lumen 960where increased friction results. This could provide an advantage ofmore than one discrete area of tactile feedback, e.g., distal of L₁′ anddistal of L₁.

With reference to FIGS. 55 and 56, the movement of the IOL 980 throughthe lumen 960 creates a plunger coefficient of friction 990 between theinner surface 968 and the abutting surface 972 of the injector plunger970, the plunger coefficient of friction being associated with a plungerfrictional force 992 that acts on the injector plunger 970 and thatresists the driving force 994 imparted on the plunger 970 by the user.As discussed above, the higher the coefficient of sliding frictionbetween the two surfaces, μ, the greater the frictional force, F,associated with one surface sliding past the other. In the embodiment ofFIG. 52, the plunger frictional force 942 (created by the frictionalsliding of the abutting surface 972 against the inner surface 968 of thelumen 960) has a smaller value when the IOL 980 is at a first location,L₁, located within the proximal portion 964 of the lumen 960, than whenthe IOL 980 is at a second location, L₂, located within the terminalportion 962.

Because of this increase in frictional force experienced by the IOL 980,the user of the injector 900 is provided with tactile feedback that theIOL 980 is nearing ejection from the distal end 966 of the lumen 960.The greater frictional force acting on the injector plunger 970 withinthe terminal portion 962 also can provide the user with greater controlover the IOL 980 during ejection.

Contact between the abutting surface 972 of the injector plunger 970 andthe inner surface 968 of the lumen 960 create a plunger coefficient offriction 990 that varies as the IOL 980 moves through the lumen 960. Theprofiles displayed in FIGS. 51A, 51B, and 51C also illustrate threepossible manners in which the plunger coefficient of friction may bevaried for the injector 900. Accordingly, the foregoing discussion ofFIGS. 51A-C with respect to the lens coefficient of friction 940 isapplicable to the plunger coefficient of friction 990 and correspondingfrictional force 992 acting on the plunger 970.

For example, similar to the friction profile illustrated in FIG. 51A,the plunger coefficient of friction 990 acting between the abuttingsurface 972 and the inner surface 968 can increase in a substantiallylinear fashion as the IOL 930 moves from the location L₁ to the locationL₂ (i.e., as the abutting surface 972 of the plunger 970 moves from thelocation L₁ ^(′) to the location L₂ ^(′)). Similar to the frictionprofile illustrated in FIG. 51B, the plunger coefficient of friction 990can be relatively constant between the location L₁ ^(′) and a transitionpoint between the locations L₁ ^(′) and L₂ ^(′) at which the coefficientabruptly increases. The coefficient of friction 990 can be at asubstantially constant, higher value between the transition point andthe location L₂ ^(′). Similar to the friction profile illustrated inFIG. 51C, the plunger coefficient of friction 990 can vary in anon-linear fashion between the locations L₁ ^(′) and L₂ ^(′), such thatthe coefficient is higher at the location L₂ ^(′) than at the locationL₁ ^(′). In each of these embodiments, the plunger coefficient offriction 990 and the corresponding frictional force 992 acting on theplunger 970 each increases as the IOL 980 approaches the distal end 966of the lumen 960. Other profiles of the plunger coefficient of friction990 and the corresponding frictional force 992 acting on the plunger 970between the locations L₁ ^(′) and L₂ ^(′) are also possible.

In another embodiment, the inner surface 968 of the lumen 960 creates aplunger coefficient of friction 990 with the plunger 970 that causes theplunger frictional force 992 to increase as the IOL 980 egresses thelumen 960. In this embodiment, the plunger coefficient of friction 990increases as the plunger 970 pushes the IOL 980 within the terminalportion 962 of the lumen 960, such that the plunger coefficient offriction 990 and the corresponding plunger frictional force 992 increaseas the IOL 980 egresses the lumen 960.

Any suitable technique may be used to control the plunger coefficient offriction 990 between the abutting surface 972 and the inner surface 968.For example, one or more of the abutting surface 972 and the innersurface 968 can be coated or partially coated in any suitable manner(such as any manner described above with respect to the distal portion912 and the proximal portion 914), can include grooves or channels (suchas the grooves 954), can include protrusions, or can be roughened.

In some embodiments, the plunger coefficient of friction 990 is causedat least in part by one or more coatings selectively covering the innersurface 968 of the lumen 960. In one embodiment, the inner surface 968includes a low-friction coating surface at a first location, L₁ ^(′),and an uncoated surface at the second location, L₂ ^(′) (see FIG. 55).In this embodiment, the locations L₁ ^(′) and L₂ ^(′) correspond to thelocations of the abutting surface 972 when the IOL 980 is at thelocations L₁ and L₂, respectively. In another embodiment, the innersurface 968 includes a high-friction coating surface at the secondlocation, L₂ ^(′), and an uncoated surface at the first location, L₁^(′). In another embodiment, the inner surface 968 includes alow-friction coating surface at the first location, L₁ ^(′), and ahigh-friction coating surface at the second location, L₂ ^(′). In otherembodiments, the inner surface includes a partially coated surface atone or both of the first and second locations, L₁ ^(′), L₂ ^(′). In someembodiments, the inner surface 968 includes partially coated surfacesthat include alternating zones of coated surface and uncoated surface.In some embodiments, at least one of the partially coated surfacesincludes a checkerboard pattern of coated surface and uncoated surface.

In some embodiments, the inner surface 968 has a greater proportion ofits area coated with a low-friction coating at the first location L₁^(′) than at the second location L₂ ^(′). In certain such embodiments,the inner surface 968 can be completely coated or partially coated withthe low-friction coating at the first location L₁ ^(′), and/or the innersurface 968 can be partially coated with the low-friction coating oruncoated at the second location L₂ ^(′).

Referring to FIG. 49, in some embodiments, a low-friction portion 951 isprovided on the outer surface 919 of the injector 900. The low-frictionportion 951 can be of a coating any suitable variety. In someembodiments, the low-friction portion 951 is adhered to, deposited on,or otherwise applied to the outer surface 919. In other embodiments, thelow-friction portion 951 is integrally formed with the material thatforms the tubular section 902. The low-friction portion 951 ispreferably configured to provide a coefficient of friction between thesurface 919 and eye tissue that is lower than a coefficient of frictionthat would otherwise exist between a tubular section of a conventionalinjector and the eye tissue. In some embodiments, the low-frictionportion 951 is hydrophilic coating. In various embodiments, a coatingmay be provided that comprises hydrophilic materials that are eitherdirectly or indirectly adhered, bonded, mechanically locked or otherwiseattached to or coupled with the material that forms the tubular section902. The hydrophilic material may be a two part polymeric coatingcomprising a supporting polymer and a hydrophilic polymer. Thesupporting polymer may be cross-linked polyacrylate that may be attachedto the outer surface 919 of the tubular section 902. If a coating 950 isapplied to an inner surface of the lumen 910, then coating or otherlow-friction portion 951 applied to the outer surface 919 can comprisethe same or similar materials as the coating 950, or may comprise adifferent material or combination of materials than the coating 950.

The low-friction portion 951 on the outer surface 919 may facilitateintroduction of the tubular section 902 into an anterior chamber of aneye by reducing the coefficient of friction that would otherwise existbetween a material conventionally used and the eye tissue, such as thecapsular bag. This reduction in friction may allow a physician to applya lower insertion force when inserting the tubular section 902 throughan incision in an eye. Additionally or alternatively, the reduction infriction may allow insertion of the IOL through a smaller incision inthe eye and/or inhibit stretching of the incision by the tubular section902. These advantages may be particularly beneficial to insertiondevices for dual-optic IOLs because some such devices employ insertionlumens that are larger than the insertion lumens employed by someinsertion devices for single-optic IOLs. Accordingly, the low-frictionportion 951 can provide the advantage of reducing trauma to the eye in anumber of ways during a procedure to implant an IOL.

FIG. 57 illustrates an embodiment of an injector 1000. The injector 1000can resemble the injector 900 in many respects. Accordingly, likefeatures are identified with like numerals. The injector 1000 can differin other respects, such as those described hereafter.

In certain embodiments, the injector 1000 includes a generally tubularsection 902 that defines a lumen 910. The lumen 910 can define anopening 917 at a distal end 916 thereof. In some embodiments, at least aportion of a plunger 920 is disposed within the lumen 910. In someembodiments, the injector 1000 further includes an expansion member1010. The expansion member 1010 can take any suitable form permittingcontrolled expansion of a lens passing therethrough. For example, invarious embodiments, the expansion member 1010 can be a sleeve (e.g., anelastomeric sleeve), membrane, energy absorption tip, or release controlsection. In many embodiments, the expansion member 1010 is at the distalend 916 of the lumen.

In certain embodiments, the expansion member 1010 comprises a flexible,supple, pliable, elastic, and/or expandable material. In someembodiments, the expansion member 1010 comprises a resilient materialcapable of expanding from a relaxed, contracted, or constricted state toa stretched, enlarged, or expanded state and returning again to theconstricted state. For example, in various embodiments, the expansionmember 1010 comprises silicone rubber, polyethylene, Pebax®, or otherpolyolephins.

The expansion member 1010 can be coupled with the tubular section 902 inany suitable manner. For example, in various embodiments, the expansionmember 1010 is bonded to, stretch fit about, or integrally formed withthe tubular section 902. In some embodiments, the expansion member 1010comprises heat shrink tubing 1012 and/or can be heat shrink bonded tothe tubular section 902.

In some embodiments, the expansion member 1010 extends a relativelysmall longitudinal distance beyond a distal tip of the tubular section902. For example, in various embodiments, the longitudinal distance isbetween about 0.001 inch and about 0.020 inch, and more preferably fromabout 0.001 inch to about 0.010 inch. In some embodiments, substantiallythe entire expansion member 1010 is sized to fit within the anteriorchamber of an eye when the injector 1000 delivers an IOL 1030 to theeye.

The IOL 1030 can comprise any suitable IOL, such as the IOL 930described above. Accordingly, the IOL 1030 can comprise a single-,dual-, or multi-optic lens. In the illustrated embodiment, the IOL 1030comprises a dual-optic system. The IOL 1030 includes a first optic 1032and a second optic 1034 that are coupled with each other via a firstbiasing member 1036 and a second biasing member 1038. Other arrangementsare also possible. In the embodiment illustrated in FIG. 57, the entireIOL 1030 is within the lumen 910, and the expansion member 1010 is inthe constricted state.

With reference to FIG. 58, in certain embodiments, the expansion member1010 is configured to absorb at least a portion of the stored mechanicalenergy of the first optic 1032 as the optic is advanced through theopening 917 of the tubular section 902 via the plunger 920. For example,in some embodiments, as the first optic 1032 exits the lumen 910, itexpands from a compacted configuration to a natural configuration. Asthe first optic 1032 expands, it stretches the expansion member 1010from the constricted configuration to the expanded configuration,thereby storing mechanical energy in the expansion member 1010. Infurther embodiments, the expansion member 1010 can dissipate energy fromthe system such as, for example, in the form of a small amount of heat.Accordingly, in various embodiments, the expansion member 1010 caninhibit sudden release of mechanical energy stored in the compactedoptic 1032 and slow entry of the IOL 1030 from the injector 1000.

In some embodiments, the IOL 1030 can emerge from the lumen 910 of itsown accord. For example, in some embodiments, the injector 1000 does notinclude an expansion member 1010, and further, can include a relativelysmooth, relatively rigid distal tip that deforms only slightly or not atall as the IOL 1030 progresses therethrough. In certain of suchembodiments, the plunger 920 can be advanced to a point where therestorative force of the IOL 1030 begins to move the IOL 1030 from thelumen 910. In some embodiments, a smooth, rigid distal tip does notsignificantly slow the release of stored mechanical energy within theIOL 1030, and in some arrangements, can permit the IOL 1030 to fullyemerge from the lumen 910 and, in further arrangements, to spring fromthe lumen 910.

In other embodiments, the injector 1000 comprises an expansion member1010 capable of dissipating energy from the IOL 1030 over a range ofmovement of the plunger 920. For example, in some embodiments, theplunger 920 can be advanced to a point where a restorative force arisesas the IOL 1030 emerges from the lumen 910. Stored mechanical energythat otherwise could cause the IOL 1030 to exit the lumen 910 entirelycan be absorbed by the expansion member 1010, thus slowing or inhibitingegress of the IOL 1030. In some embodiments, once a portion of the IOL1030 initially emerges from the lumen 910 and begins to releasemechanical energy, the plunger 920 continues to travel through adistance in order to urge the IOL 1030 from the lumen 910. In variousembodiments, this distance is no less than about 5%, no less than about10%, no less than about 15%, no less than about 20%, or no less thanabout 25% the total distance traveled by the plunger 920 to advance theIOL 1030 in a distal direction.

In some embodiments, the expansion member 1010 retains the first optic1032 until the second optic 1034 is forced into the expansion member1010. For example, in some embodiments, the expansion member 1010comprises a material having a relatively high coefficient of frictionwhen in contact with the material(s) of which the first and/or secondoptics 1032, 1034 are composed. The expansion member 1010 can thusresist movement of the first optic 1032 as it releases stored mechanicalenergy to achieve its natural configuration and/or as the second optic1032 is advanced into the expansion member 1010. Accordingly, in someembodiments, the expansion member 1010 can provide controlled deliveryof the first optic 1032 to an eye.

With reference to FIG. 59, in some embodiments, the expansion member1010 is capable of retaining the second optic 1034 stationary after thefirst optic 1032 has exited the expansion member 1010. In furtherembodiments, the expansion member 1010 is configured retain the secondoptic 1034 substantially stationary relative to the injector 1000 aftera substantial portion of the second optic 1034 has exited the lumen 910.For example, the expansion member 1010 can stretch to the expandedconfiguration as the second optic 1034 egresses the lumen 910, therebyresisting movement of the second optic 1034 out of the lumen 910.Accordingly, the plunger 920 can be used to urge the second optic 1034from the lumen 910 in a controlled manner.

Any suitable combination of the features of the various injectorsdisclosed herein can be made. For example, compatible features of theinjector 1000 can be combined with features of the injector 900. In someembodiments, the release control sections 912 and the expansion member1010 can be combined in a single embodiment. As another example, in someembodiments, an expansion member 1010 can be fitted to a distal end ofthe tubular section 902 of the injector 900. Accordingly, a distal edgeof the tubular section 902 can be angled, as illustrated in FIGS. 54A-D.In certain of such embodiments, the expansion member 1010 also isangled, and can extend longitudinally beyond the distal edge of thetubular section 902 by a substantially fixed amount.

FIGS. 60 and 61 illustrate an embodiment of an injector 1100. Theinjector 1100 can resemble the injector 900 in many respects, and candiffer in other respects such as those described hereafter. In someembodiments, the injector 1100 resembles the embodiments of the injector900 illustrated in FIGS. 54A-D, except that the distal end 916 of thetubular section 902 is substantially flattened. For example, in someembodiments, the distal end 916 is elongated along a first plane througha longitudinal axis of the tubular section 902, and is relatively narrowalong a second plane through the longitudinal axis of the tubularsection 902. The first and second planes can be perpendicular to eachother.

In some embodiments, the relatively narrow profile of the injector 1100can advantageously correspond more closely with a linear incision sitethan can certain other profiles. Accordingly, the injector 1100 may bemore easily inserted into an eye in some instances, and may provide fora smaller incision site. In some embodiments, the narrow profile canalso apply a retarding pressure against an IOL being inserted in theeye, thereby slowing an exit velocity of the IOL.

A flattened profile of the distal end 916 of the injector 1100 can beachieved in any suitable manner. For example, in some embodiments, thedistal end 916 is molded to include a flattened profile, and in otherembodiments, the distal end 916 is heated and mechanically flattened.Other methods may also be used.

FIG. 62 illustrates another embodiment of the injector 1100. In theillustrated embodiment, a top portion 1112 and a bottom portion 1114 ofthe distal end 916 contact each other in at least one position. In someembodiments, the top and bottom portions 1112, 1114 are configured toseparate or expand to another position to permit an IOL to passtherethrough. In some embodiments, the injector 1100 provides additionalresistance to passage of an IOL than do certain embodiments of theinjector 1100 illustrated in FIG. 61. The amount of separation betweenthe top and bottom portions 1112, 1114 and/or the flexibility of the topand bottom portions 1112, 1114 can be optimized to achieve a desireddegree of resistance to an IOL.

Any suitable combination of the embodiments described herein ispossible. For example, any suitable combination of the embodimentsdescribed with respect to FIGS. 49-54 with the embodiments describedwith respect to FIGS. 55 and 56 is possible. Furthermore, any suitablecombination of the embodiments described with respect to FIGS. 49-56with any of the embodiments described with respect to FIGS. 57-62 ispossible. Any suitable combination of the embodiments described withrespect to FIGS. 1-48 with the various embodiments described withrespect to FIGS. 49-62 is also possible.

Although the invention(s) have been disclosed in the context of certainpreferred embodiments and examples, it will be understood by thoseskilled in the art that the invention(s) extend beyond the specificallydisclosed embodiments to other alternative embodiments and/or uses ofthe invention(s) and obvious modifications and equivalents thereof.Thus, it is intended that the scope of the invention(s) herein disclosedshould not be limited by the particular embodiments described above, butshould be determined only by a fair reading of the claims that follow.

What is claimed is:
 1. A method of operating an injector having anintraocular lens disposed therein, the injector comprising a lumenhaving a terminal portion at a distal end thereof and a proximal portionjuxtaposed with said terminal portion, said lumen comprising an innersurface, said terminal portion including an outlet, the methodcomprising: exerting a first lens frictional force on the intraocularlens when the lens is at a first location within said proximal portion,the first location having a smooth surface with a lubricious coatingdisposed thereon, said first lens frictional force being associated witha first lens coefficient of friction between the lens and said innersurface at the first location; and exerting a second lens frictionalforce on the intraocular lens when the lens is at a second locationwithin said terminal portion, said second lens frictional force beingassociated with a second lens coefficient of friction between the lensand said inner surface that is larger than first lens coefficient offriction due to the second location being free of the lubriciouscoating.
 2. The method of claim 1, further comprising varying a lenscoefficient of friction gradually from said first lens coefficient offriction to said second lens coefficient of friction during the passageof the lens from said first location to said second location.
 3. Themethod of claim 1, further comprising varying a lens coefficient offriction abruptly from said first lens coefficient of friction to saidsecond lens coefficient of friction during the passage of the lens fromsaid first location to said second location.
 4. The method of claim 1,further comprising providing a tactile feedback to a user of theinjector via transition from said first lens coefficient of friction tosaid second lens coefficient of friction.
 5. The method of claim 1,further comprising slowing egress of the intraocular lens from saiddistal end of said lumen via said second lens coefficient of friction.6. A method of operating an injector having an intraocular lens disposedtherein, the injector comprising a lumen having a terminal portionincluding an outlet at a distal end thereof and a proximal portionjuxtaposed with said terminal portion, said lumen comprising an innersurface, the method comprising: advancing the intraocular lens towardthe distal end of the lumen; exerting a first lens frictional force onthe intraocular lens when the lens is at a first location within saidproximal portion, the first location having a smooth surface with alubricious coating surrounding and extending axially along the lumen,said first lens frictional force being associated with a first lenscoefficient of friction between the lens and said inner surface;exerting a second lens frictional force on the intraocular lens when thelens is at a second location within said terminal portion, thefrictional force applied to the lens abruptly increasing from the firstfrictional force to the second frictional force at the second location,said second lens frictional force being associated with a second lenscoefficient of friction between the lens and said inner surface, whereinsaid second lens frictional force is larger than said first lenscoefficient of friction and the second location is free of thelubricious coating.
 7. The method of claim 6, further comprisingproviding a tactile feedback to a user of the injector via transitionfrom said first lens frictional force to said second lens frictionalforce.
 8. The method of claim 6, further comprising slowing egress ofthe intraocular lens from said distal end of said lumen via said secondlens frictional force.
 9. The method of claim 6, wherein the second lensfrictional force counteracts at least a restorative force imparted tothe intraocular lens due to a release of mechanical energy stored in theintraocular lens.